Therapeutic adherence and health outcomes in acute coronary syndrome (SCA) patient: the role of nursing

Abstract

Background and aim: The literature on cardiovascular disease has highlighted that therapeutic adherence is often inadequate. What are the reasons for this poor adherence to medication? The goal has been to measure the different factors related to therapeutic adherence,  differentiating the SCA patients on three levels of self-referred therapeutic adherence and delving the relations between self-reported therapeutic adherence and socio-demographic, clinical, emotive, cognitive and socio-relational variables. Method: A total of 84 Italian patients (66.7% males) with (SCA) took part in the study and completed a semi-structured questionnaire investigating the variables described above. Results: Results indicate the influence of clinical variables, showing that patients suffer more of dyspnea and angina symptoms than those that state to follow prescriptions. But the emotive aspects seem able to interfere more with the adherence: the subjects scarcely adherent have felt more threatened by their illness, and experimented more symptoms of anxiety and sadness than highly adherent patients. At a cognitive level the adherent patients have chosen coping strategies not centred on emotions, but headed to the solution of the problem. At socio-relational level is confirmed the importance of the social support in favouring the adherence. Conclusions: Among the different factors here considered, are those psychological and relational that tend to be associated to level of adherence for prescriptions. The outcomes have shown that the demo-graphical and clinical variables result are not tightly associated to the adherence, confirning instead the importance of psycho-social factors, as already notable in the literature in heart studies. The implications have been discussed.